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Home birth danger claim rejected

The Royal College of Midwives (RCM) has rejected claims by leading medical journal The Lancet that giving birth at home is too risky.

The trade union strongly criticised an editorial by the magazine, which highlighted research suggesting home birth can triple the risk of infant death. Childbirth is "not an illness", the midwives said, adding that giving birth in the home is generally safe.

Dr Joseph Wax, based at Maine Medical Centre in New Hampshire, led a study which looked at data on nearly 550,000 births in North America, Europe and Australia. He concluded that, for healthy women, home births doubled the risk of a newborn baby dying and when children born with congenital defects were taken out of the equation, the rate of deaths increased by three times.

A total rate of 3% of all UK births happen in the home, three times the rate of that in the US but far less than that of The Netherlands, where around one third of births take place at home.

The Lancet insisted that the US research, the results of which were published in the American Journal of Obstetrics & Gynaecology, gave "the strongest evidence so far" that giving birth at home "can be harmful to newborn babies".

RCM General Secretary, Cathy Warwick, said: "We are deeply disappointed and dismayed that The Lancet has published an editorial indicating that women would choose to harm their baby in favour of their own needs by choosing a home birth.

"The editorial also cites research that is incomplete and methodologically flawed. There is no evidence to suggest that hospital births are safer than home births."

Copyright © Press Association 2010

The Lancet

Your comments (terms and conditions apply):

"The American research cited above is flawed. Critiques have already been published by American research specialists skilled in research methodology. It is well known that doctors believe their own anecdotal material and are not entitled to be called doctor unless they have done a PhD. Quantitative and qualitative research is not included in the sphere of clinical based training and neither is home birth or midwifery practice included in the clinical experience of most obstetricians. A small percentage of the high income earning specialists have a fear of midwives' superior knowledge about normal birth and what women want. The desire for control and the financial incentives drives poorly designed studies. It is well known the most often research relied on by doctors is from their own journals funded by pharmaceutical companies. How valid is that. In one major medical journal research by a doctor about dog bites treated by him had the doctor claiming evidence the the most common dog was one particular breed based on his anecdotal evidence.  The cited American research above was demonstrated to selectively lift out literature suited to the outcome the writers unethically chose. Major best practice recently performed internationally published research was left out" - Beverley Walker, Australia

"CESDI research presented almost 10 years ago in the West Midlands showed a similar finding with the risk of planned homebirth increasing the risk of death at least twofold compared to hopsital births. Bearing in mind that hospitals deliver the really high risk mothers and babies this is very worrying as the only risk factors for these babies is the mother's decision to deliver at home" - Bryan Beattie, UK